What To Expect After Prostate Radiation

Remission And The Chance Of Recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.

Possible Side Effects Of Radiation Treatment For Prostate Cancer

The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.

You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.

How Can I Reduce Skin Reactions

• Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Donât rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
• Try not to scratch or rub the treated area.
• Donât put any ointment, cream, lotion, or powder on the treated area unless your radiation oncologist or nurse has prescribed it.
• Donât wear tight-fitting clothing or clothes made from harsh fabrics like wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers like cotton.
• Donât apply medical tape or bandages to the treated area.
• Donât expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
• Donât expose the treated area to direct sunlight. That could intensify your skin reaction and lead to a severe sunburn. Choose a sunscreen of SPF 30 or higher. Protect the treated area from direct sunlight even after your course of treatment is over.

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How You Might Feel

Being diagnosed with prostate cancer can be stressful. It is natural to have a wide variety of emotions after the diagnosis and during treatment, including anger, fear anxiety, sadness and resentment. These feelings may become stronger over time as you adjust to the physical side effects of treatment.

Everyone has their own ways of coping with their emotions. There is no right or wrong way. It is important to give yourself and those around you time to deal with the emotions that cancer can cause. For support, call Cancer Council 13 11 20.

If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.

If you think you may be depressed or feel that your emotions are affecting your day-to-day life, talk to your GP. Counselling or medication even for a short time may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.

For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636. For 24-hour crisis support, call Lifeline 13 11 14.

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What Happens On Treatment Days

If you get external radiation therapy, youâll need to get regular sessions during a period of about 5 to 8 weeks.

For each treatment, the radiation therapist will help you onto the treatment table and into the correct position. Once the therapist is sure youâre positioned well, theyâll leave the room and start the radiation treatment.

Theyâll watch you closely during the treatment. Cameras and an intercom are in the treatment room, so the therapist can always see and hear you. Try to stay still and relaxed during treatment. Let the therapist know if you have any problems or you feel uncomfortable.

Theyâll be in and out of the room to reposition the machine and change your position. The treatment machine wonât touch you, and youâll feel nothing during the treatment. Once the treatment is done, the therapist will help you off the treatment table.

The radiation therapist will take a port film, also known as an X-ray, on the first day of treatment and about every week thereafter. Port films verify that youâre being positioned accurately during your treatments.

Port films donât provide diagnostic information, so radiation therapists canât learn about your progress from them. But these films do help the therapists make sure theyâre delivering radiation to the precise area that needs treatment.

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If Prostate Cancer Returns

Sometimes prostate cancer does come back after treatment, which is known as a recurrence. If your PSA level starts to rise and the cancer has not spread beyond the prostate, this may mean you still have cancer cells in the prostate area. If this happens, you may be monitored with regular blood tests or you may be offered further treatment, which is known as salvage treatment.

Your options will depend on the treatment you had. If you had surgery, you may be offered radiation therapy, and if you had radiation therapy, you may be offered further radiation therapy, surgery or other treatments. If the cancer has spread beyond the prostate, androgen deprivation therapy is usually recommended and sometimes radiation therapy may be recommended. Surgery may be an option in some cases. You may be offered palliative treatment to manage symptoms.

It is possible for the cancer to come back in another part of your body. In this case, you may have treatment that focuses on the area where the cancer has returned. Talk to your doctors about the options. You can also call Cancer Council 13 11 20 for more information.

Vitamins And Dietary Supplements

Its OK to take a multivitamin during your radiation therapy. Do not take more than the recommended daily allowance of any vitamin or mineral.

Dont take any other dietary supplements without talking with a member of your care team. Vitamins, minerals, and herbal or botanical supplements are examples of dietary supplements.

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What Happens During External

What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive. External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.

Each session is generally quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine.

Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.

This type of radiation therapy only targets the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until after the treatment period is complete. Let your health care team know if you are experiencing any side effects so they can help relieve them. Read more about the side effects of radiation therapy.

The Risk Of Your Cancer Coming Back

For many men with localised or locally advanced prostate cancer, treatment is successful and gets rid of the cancer. But sometimes not all the cancer is successfully treated, or the cancer may have been more advanced than first thought. If this happens, your cancer may come back this is known as recurrent prostate cancer.

One of the aims of your follow-up appointments is to check for any signs that your cancer has come back. If your cancer does come back, there are treatments available that aim to control or get rid of the cancer.

Your doctor cant say for certain whether your cancer will come back. They can only tell you how likely this is.

When your prostate cancer was first diagnosed, your doctor may have talked about the risk of your cancer coming back after treatment. To work out your risk, your doctor will have looked at your PSA level, your Gleason score and the stage of your cancer. If your prostate has been removed, it will have been sent to a laboratory for further tests. This can give a better idea of how aggressive the cancer was and whether it is likely to spread. If you dont know these details, ask your doctor or nurse.

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Prostate Cancer: Radiation Therapy

Radiation therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing while minimizing damage to healthy cells.

Radiation can be given from a machine outside the body and directed at the prostate . Or a surgeon can place radioactive materials into the tumor . These radioactive materials can be temporary or permanent.

What Is 3d Conformal Radiation Therapy

Itâs a procedure that uses a computer to make a three-dimensional picture of your tumor. It helps your treatment team deliver the highest possible dose of radiation to the tumor while minimizing the damage to normal tissue.

3D conformal radiation therapy uses CT-based treatment combined with three-dimensional images of a prostate tumor. CT is short for computed tomography, which uses X-rays to produce detailed pictures inside the body.

So far, this technique has worked well for localized tumors such as prostate cancer limited to the prostate gland.

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Ask Your Doctor About Solutions

Patients should not be shy about discussing intimacy issues with their doctor. He or she may be able to prescribe medications to help. Certain medicationssuch as sildenafil , tadalafil or vardenafil are typically tried first. But these drugs may not help men achieve an erection if the nerves responsible are not healthy. In fact, the medications only work for a small percentage of men in the first few months after surgery, according to a 2017 study published in the International Journal of Sexual Health.

While regaining erectile function is not possible for all men treated for prostate cancer, it is important to remember that an erection is just one aspect of a satisfying sex life. Intimacy is another major component, one that may become more important as sexual relationships become more difficult after cancer treatment.

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How Can I Help Myself

Urinary problems can affect your self-esteem and independence, and affect your work, social and sex life.

Making some changes to your lifestyle may help, and there are some practical steps that can make things easier.

• Try to drink plenty of fluids, but cut down on fizzy drinks, alcohol, tea and coffee as these may irritate the bladder
• Do regular pelvic floor muscle exercises to help strengthen the muscles that control when you urinate.
• Try to stay a healthy weight. Being overweight can put pressure on your bladder and pelvic floor muscles.
• If you smoke, try to stop. Smoking can cause coughing which puts pressure on your pelvic floor muscles. NHS Choices has more information about stopping smoking
• Plan ahead when you go out. For example, find out where there are public toilets before leaving home.
• Pack a bag with extra pads, underwear and wet wipes. Some men also find it useful to carry a screw-top container in case they cant find a toilet.
• Get our Urgent toilet card to help make it easier to ask for urgent access to a toilet.
• Disability Rights UK runs a National Key Scheme for anyone who needs access to locked public toilets across the UK because of a disability or health condition.
• If you often need to use the toilet at night, leave a light on in case youre in a hurry, or keep a container near your bed.

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Advantages And Disadvantages Of External Beam Radiotherapy

Advantages

• You dont need a general anaesthetic and you dont need to stay overnight in hospital.
• You may be able to work and carry on normal activities during the treatment.
• You are not radioactive during or after the treatment so you can be in close contact with others.
• Each treatment is relatively short. It usually takes about 15 minutes, although you may be in the radiotherapy department for up to an hour.

Disadvantages

Radiation Therapy Is Proven Effective

At MRO, we use radiation, or radiotherapy, to destroy cancer cells with high doses of radiation, the same type used for x-rays. Using a medical linear accelerator , we direct precise doses of radiation at cancer cells, which are more susceptible to radiation than healthy cells. Like an x-ray, radiation therapy is painless. And theres no fear of becoming radioactive during or after treatment.

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What To Know About Radiation Therapy For Prostate Cancer

As treatment options for prostate cancer get better, it can be tough for men to understand what to expect, especially when it comes to radiation therapy.

Its critical that men find a care location that not only offers the latest clinical advancements, but has an experienced and diverse team that treats all aspects of cancer, including the physical, functional and emotional aspects of the disease, shares Glen Gejerman, M.D., co-director of urologic oncology at Hackensack Meridian Healths John Theurer Cancer Center.

Dr. Gejerman, as well as radiation oncologists Prashant Desai, M.D., medical director of radiation oncology at Ocean Medical Center and Priti Patel, M.D., medical director of radiation oncology at Riverview Medical Center, helped answer some of the most commonly asked questions about radiation therapy for prostate cancer below.

Q: What are the different types of radiation therapy for prostate cancer?

There are several forms of radiation therapy, but they can be broken down into two main categories:

External Beam Radiation â This form of therapy is more common, and delivers radiation from outside your body to treat cancer. This type of therapy can be used on its own or in combination with brachytherapy, depending on how aggressive your cancer is. There are three main techniques of delivering EBRT for prostate cancer:

Q: Is radiation therapy painful?

Q: Is radiation therapy safe?

Q: When is radiation therapy the right choice?

When Is Brachytherapy Alone The Right Choice

For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.

But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.

This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.

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What Happens After Radiation Therapy Treatment Ends

Once treatment ends, you will have follow-up appointments with the radiation oncologist. Itâs important to continue your follow-up care, which includes:

• Checking on your recovery

• Watching for treatment side effects, which may not happen right away

As your body heals, you will need fewer follow-up visits. Ask your doctor for a written record of your treatment. This is a helpful resource as you manage your long-term health care.

Fiducial Markers And Spaceoar

For prostate stereotactic body radiation therapy at Valley, we first implant fiducial markers and SpaceOAR hydrogel.

These are implanted in one 30-minute procedure. The implantation is performed under general anesthesia in our same-day surgical center within the cancer center.

• Fiducial markers are tiny gold markers that we implant in your prostate. Fiducials guide our delivery of radiation by enhancing our ability to detect subtle changes in prostate position. Because the markers show up on imaging, we are able to deliver radiation more accurately and consistently at each session.
• SpaceOAR is a semi-solid gel that creates space between your prostate and rectum. This extra space protects your rectum from radiation and reduces radiation side effects.

How to Prepare for Fiducial and SpaceOAR Implantation

You will need to have additional tests to be cleared for the implantation procedure.

Nurses in our office will walk you through the scheduling process for the procedure and the tests you need. You will leave your first visit with us with an appointment for the implantation procedure.

We will also give you information about how to prepare for your procedure. This will include instructions to:

• Take an antibiotic for five days starting one day before the procedure
• Perform an enema at home following instructions we will provide
• Not eat or drink after midnight the night before the procedure

Fiducial and SpaceOAR Implantation

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